Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-23T17:51:44.628Z Has data issue: false hasContentIssue false

Defining benzodiazepine dependence: the confusion persists

Published online by Cambridge University Press:  16 April 2020

SM Linsen
Affiliation:
Departments of Psychiatry, Catholic University Nijmegen, PO Box 9101 6500 HB Nijmegen, The Netherlands
FG Zitman*
Affiliation:
Departments of Psychiatry, Catholic University Nijmegen, PO Box 9101 6500 HB Nijmegen, The Netherlands
MHM Breteler
Affiliation:
Clinical Psychology, Catholic University Nijmegen, PO Box 9101 6500 HB Nijmegen, The Netherlands
*
*Correspondence and reprints.
Get access

Summary

Little consensus exists on the risk of benzodiazepine (BZD) dependence. We investigated how often BZD dependence and related concepts have been defined in the literature on BZD effects in humans. In addition, the definitions of BZD dependence were compared in order to assess the similarity of contents. From a total of 250 papers (published between 1988 and 1991) 51 provided 126 dependence-related definitions. Six studies referred to the DSM definitions and one to the WHO definition. The obsolete concept of addiction was frequently defined (n=13), with little consensus about its meaning. Psychological and physical dependence were defined fairly often (n=29), also with low levels of consensus. We conclude that the discussion on the risk of BZD dependence would be well-served by attempting to improve consensus first. This may lead to more meaningful data on the incidence, prevalence and relevant co-factors of BZD dependence. An outline for criteria for benzodiazepine dependence is presented.

Type
Original article
Copyright
Copyright © Elsevier, Paris 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders 3rd Ed. Washington : American Psychiatric Association, 1980Google Scholar
American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders 3rd edition revised. Washington: American Psychiatric Association, 1987Google Scholar
American Psychiatric Association APA task force report on benzodiazepine dependence, toxicity and abuse. Washington: American Psychiatric Association, 1990Google Scholar
Anitto, WJAlcoholics' use of benzodiazepines (letter). Am J Psychiatry. 1989;46:636-84Google Scholar
Busto, UESellers, EMAnxiolytics and sedative hypnotic dependence. Br J Addict. 1991;86:1647-52CrossRefGoogle Scholar
DuPont, RLChoosing the right treatment for the patient with anxiety. Mod Med. 1992;60:64-76Google Scholar
Farnsworth, MGBenzodiazepine abuse and dependence: misconceptions and facts. J Family Pract. 1990;31:393-400Google ScholarPubMed
Geiselmann, BLinden, MSachs, GEricsson, NBenzodiazepine prescriptions and therapist non compliance. Eur Arch Psychiatr Neurol Sci. 1989;239:180-87CrossRefGoogle ScholarPubMed
Gottschalk, LAAffective and cognitive problems with the benzodiazepines (letter). J Clin Psychopharmacol. 1988;8:223-5CrossRefGoogle ScholarPubMed
Jaffe, JHTrivializing dependence. Br J Addict. 1990;85:1425-7CrossRefGoogle ScholarPubMed
Juergens, SMBenzodiazepines and addiction. Psychiatr Clin North Am. 1993;16:75-86CrossRefGoogle ScholarPubMed
Kräupl Taylor, FThe damnation of the benzodiazepines. Br J Psychiatry. 1989;154:697-704Google Scholar
Lader, MBenzodiazepine dependence. Int Rev Psychiatry 1989;l:149-56CrossRefGoogle Scholar
Ladewig, DGrossenbacher, HBenzodiazepine abuse in patients of doctors in domiciliary practice in the Basle area. Pharmacopsychiat. 1988;21:104-8CrossRefGoogle ScholarPubMed
Marks, IReply to comments on “behavioural (non-chemical) addictions”. Br J Addict. 1990;85:1429-31Google Scholar
Marks, JThe benzodiazepines. Use, overuse, misuse. Lancaster: MTP Press, 1978Google Scholar
Miller, NSGold, MSIdentification and treatment of benzodiazepine abuse. Am Fam Phys. 1989;40:175-83Google ScholarPubMed
Miller, NSGold, MSBenzodiazepines: tolerance, dependence, abuse and addiction. J Psychoact Drugs. 1990;22:23-33CrossRefGoogle ScholarPubMed
Miller, NSGold, MSBenzodiazepines: reconsidered. Adv Alcohol Subst Abuse. 1990;8:67-84CrossRefGoogle ScholarPubMed
Noyes, RGarvey, MJCook, BLPerry, PJBenzodiazepine withdrawal: a review of the evidence. J Clin Psychiatry. 1988;49:382-9Google Scholar
Rifkin, ABenzodiazepines for anxiety disorders. Are the concerns justified?. Postgrad Med. 1990;87:209-20CrossRefGoogle ScholarPubMed
Rinaldi, RCSteindler, EMWilford, BBGoodwin, DClarification and standardization of substance abuse terminology. JAMA. 1988;259:555-7CrossRefGoogle ScholarPubMed
Roache, JDAddiction potential of benzodiazepines and benzodiazepine anxiolytics. Adv Alcohol Subst Abuse. 1990;9:103-28CrossRefGoogle ScholarPubMed
Rosenbaum, JFPattison, JFMundjack, DJPollack, MHSachs, GSQuestions and discussions. J Clin Psychiatry. 1990;51(suppl):50-3Google Scholar
Roy, Byrne PPHommer, DBenzodiazepine withdrawal: overview and implications for the treatment of anxiety. Am J Med. 1988;84:1041-52Google Scholar
Salzman, CThe APA task force report on benzodiazepine dependence, toxicity, and abuse. Am J Psychiatry. 1991;148:151-2Google Scholar
Sussman, NTreating anxiety while minimizing abuse and dependence. J Clin Psychiatry. 1993;5(suppl):44-51Google Scholar
Talley, JHBut what if a patient gets hooked? Fallacies about long term use of benzodiazepines. Postgrad Med. 1990;87:187-203CrossRefGoogle ScholarPubMed
Teboul, EChouinard, GA guide to benzodiazepine selection. Part I: Pharmacological aspects. Can J Psychiatry. 1990;35:700-10Google ScholarPubMed
Teboul, EChouinard, GA guide to benzodiazepine selection. Part II: Clinical aspects. Can J Psychiatry. 1991;36:62-73CrossRefGoogle ScholarPubMed
Tyrer, PMurphy, SRiley, PThe benzodiazepine withdrawal symptom questionnaire. J Aff Disord. 1990;19:53-61CrossRefGoogle ScholarPubMed
Uhlenhuth, EHDeWitt, HBalter, MBJohanson, CERisks and benefits of long term benzodiazepine use. J Clin Psychopharmacol. 1988;8:161-7CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.